Running Head: MENTAL HEALTH
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Career Mental Health Counseling with Asian Americans
Diane Johnson
Liberty University
2/29/2020
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Abstract
Over the years, the Asian population, both immigrants and United States-born, has
been experiencing behavior and mental challenges. Due to the lack of sufficient
psychological institutions that match their cultural beliefs, this culture is reluctant to
seek psychotherapy services in America. Asian traditional values have worsened the
situation by explaining the human mind and body as independent rather than dualistic.
Also, the stereotype minority model and other misconceptions have significantly
contributed to the underutilization of psychological therapy in the Asian community.
Besides, the Asian community comprises of 28 cultural groups with varying
educational achievements or career success rates. However, Asians are commonly
classified in one category, with the accomplishments of one subgroup given to the
entire race. The primary causes of the elevated risks of developing mental issues
among Asian-Americans are gender discrimination, language barrier, racism, sexual
harassment, neighborhood, financial capability, stereotypes, traditional values, and
family structure. This paper focuses on the mental health status of Asian-Americans
and offers appropriate therapeutic strategies.
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Career Mental Health Counseling with Asian Americans
Today, over 19 million Asian-Americans live in the United States. In 2000, 13%
of this population was diagnosed with mental illness, but research shows they are
three times less likely than White Americans to seek treatment. Only 8.6% of the
entire Asian-American population get professional help concerning mental health and
often end the treatment program prematurely (Askarinam, 2016). Several factors
contribute to the reluctance of Asian-Americans to seek mental health treatment,
including lack of resources, myths, stigma, language barriers, and lack of awareness,
among others. It is significant to understand the psychological problems surrounding
Asian-Americans to reduce the suicide rates in a rapidly growing ethnic society,
which is expected to be 6.2% of the United States population by 2025 (Askarinam,
2016). This paper aims to create awareness on career mental issues among Asian-
Americans and develop an effective counseling strategy for the affected individuals.
Cultural Awareness
Tuliao's journal article on "career-building among Asian Americans" shows a 5%
increase in higher education entries of Asian-American or Pacific Islanders (AAPI)
students from 1976 to 2014. However, in a total of 20 million college enrolments in
2015, only 7 % were AAPI (Tuliao, 2018). One primary cause of fewer numbers of
Asian-Americans in higher education institutions is the misconception that they all
attend private universities. On the contrary, the majority are in public learning
institutions. For instance, 47% of AAPI enrolled at local or community colleges in
2005 (Tuliao, 2018). This misconception results in the assumption that Asian-
Americans are superior, and thus are prevented from accessing resources, services, or
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opportunities reserved for minority races. The consequence of such misconceptions is
higher numbers of mentally disturbed Asian-American students.
Another factor that contributes to a lack of awareness on the reduced value of
education Asian Americans receive is the minority stereotype, where Asians,
especially those residing in America, are assumed to be career-driven, educated, and
successful members of society, who abide by the law. This stereotype is fueled by the
work ethic of Asian Americans, and the perception that they are not prone to racism
(Tuliao, 2018). As a result, the Asian-American ethnic group is viewed as
homogeneous rather than diverse. Often, people see Asian-Americans as problem-
free, which is entirely wrong. Asian-Americans, especially college students,
experience depression, and other mental health issues, but hesitate in asking for
medical assistance because of the high levels of expectations imposed on them by
cultural myths and misconceptions.
The mental health struggles of Asian-Americans do not end in higher education
institutions. The minority myth on Asian-Americans brands them as "forever
foreigners," which is manifested in day-to-day conversations. For example, despite
having American citizenship, Asian-Americans are often asked where they come
from. Finding employment in America with an Asian name on your resume is very
difficult regardless of the educational level attained or skills possessed. Research
shows that Asian applicants are 28% less likely than Whites to receive a callback
from employers (Askarinam, 2016). The language barrier is mainly the cause since
employers believe Asian-Americans cannot speak good English. Hiring
discriminations has led to the adoption of new English names by the majority of
Asian-Americans with the hope of whitening their curriculum vitae. Lack of
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employment and the abandonment of their culture, including names, increase the
chances of developing mental problems among Asian Americans.
A study on cultural values and career choices among Asians explains the limited
number of Asian-Americans in K-12 jobs. Despite the increasing number of Asian-
American students, the population of Asian teachers or principals has remained
constant over the years. In 2016, Asian K-12 principals comprised 2% of the
American people. Several Asian cultural values greatly influence their career choices,
including the tendency of selecting occupations that concentrate more on science and
engineering (Chan-Nauli, 2018). The culture of humility and collectivism among
Asians causes them to care about others more and prevents them from showing off
their accomplishments, thereby hindering their chances of job promotion.
Besides, the conservative nature of Asians makes interactions with superiors
difficult. Another cultural value is the preference of careers with extrinsic
motivational outcomes such as prestige, big salaries, and job security, among others.
The fifth cultural aspect is the selection of jobs based on the family's interests. In the
majority of Asian-American homes, career choices are made by parents who do not
value professions such as teaching (Chan-Nauli, 2018). Asian-American college
students end up pursuing traditional careers due to pressure from their families rather
than their desires.
Moreover, the cultural trend of conformity and emotional self-awareness with
fewer expressions in the Asian community contributes to a few numbers in careers
dependent on social skills and networking. Homophily is the seventh cultural factor
that impact career choice among Asian-Americans (Chan-Nauli, 2018). Homophily
refers to the habit of developing relationships with individuals with similar features
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and characteristics as yours. According to the 2007 census, 25% of Asian-Americans
are engineers, 30% are scientists, 17% are physicians, 14% are dentists, and 1% or
less are social workers (Chan-Nauli, 2018). These statistics are primarily influenced
by the seven cultural values discussed above.
A study conducted by Buchanan and colleagues on Asian-American women
concerning gender and sexual harassment shows that 89.1% of the studied population
has experienced either or both forms of harassment. In a sample of 129 women,
64.3% face unwanted sexual tension, 36.4% experience gender discrimination, and
24.8% are sexually coerced (Buchanan, Settles, Wu, & Hayashino, 2018). The high
rate of unwanted sexual attention is due to the misconception that Asian-American
women are sexually submissive and available. Regardless of the large numbers in
gender discrimination, women were less likely to report this type of harassment,
because the minority model normalizes the involvement of Asian-American women in
education and other sectors.
Similar to other researches, Buchanan et al. associates sexual and gender
harassment with psychological problems. Despite gender discrimination being
common among Asian women, it causes the least amount of depression, perhaps
because it is less intense compared to sexual harassment (Buchanan, Settles, Wu, &
Hayashino, 2018). Usually, victims of sexual coercion develop post-traumatic stress,
which clinicians should keep an eye for when treating Asian-American women with
mental issues.
Another disturbing misconception about Asian-Americans is their
socioeconomic status. Regardless of Asian-Americans being financially stable than
other minor races, their poverty rates are 50% higher when compared to Whites. The
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majority of Asian-Americans receive low or medium incomes while working more
than one job (Kim, Kendall, & Cheon, 2017). Those that are highly educated and
work in fields of medicine or engineering are hardly promoted due to racism, gender
discrimination, or sexism. The myth that Asian-Americans are financially capable
increases the pressure of meeting these standards by overworking, thereby initiating
mental problems.
The fear of shaming one's family significantly results in the under-utilization of
medical facilities by Asian-Americans. Seeking medical assistance is similar to
admitting a mental problem that exists in a family (Kim, Kendall, & Cheon, 2017). In
Asian families, each member is responsible for maintaining the right image.
Therefore, agreeing to have mental issues will tint the family image if the information
becomes public.
Immigrants born in the United States are at a higher risk of developing mental
problems compared to those born in their country of origin. Immigrants who arrived
in the United States below the age of seven have a higher probability of experiencing
mental issues than those who migrated after adolescent years (Alegría, Álvarez, &
DiMarzio, 2017). However, the longer these immigrants stay in America, the higher
the risk for mental health disorders. In general, United States-born immigrants have a
higher prevalence of depression and suicidal attempts than foreign-born immigrants.
Immigrants born in the United States have a lower lifetime prevalence compared to
those who entered the country as children. The prevalence rates differ among
immigrants because of factors such as family cohesion, social support, language use,
transnational ties, and acculturative stress (Alegría, Álvarez, & DiMarzio, 2017). For
example, Asian immigrants with minimum family-cohesion levels, are more likely to
experience depression or other forms of psychiatric disorder.
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Counseling Approach
The ethnic group leading in retaliation from medical treatment of mental
problems is Asian-American by 69%, followed by Hispanics with 64%, then Africa-
Americans with 59%, and Whites by 40%. Seeking help on mental health from other
institutions other than medical practitioners is shared among the Asian community.
Research shows that only 28% of the diagnosed population got help from
psychologists or other mental health specialists in 2015 (Katigbak, Foley, Robert, &
Hutchinson, 2016). The rest opt for un-professional methods such as religious groups,
online services, and many more. Enhancing multicultural counseling competence is
the primary solution to this problem. The literature on multicultural counseling
provides methods for White counselors to offer cultural and sensitive therapy to
minority races.
The first session is always the hardest. The few Asian clients who attend therapy
sessions expect to find answers to their problems after the first attempt, which is never
the case. The first strategy to ensure an Asian patient returns after the first therapy
meeting is to show authority and expertise(Jang, Park, Chiriboga, & Kim, 2017).
Respect for authority is one of the many Asian cultural values, which will keep a
client if exercised. Also, the therapist should maintain a formal tone when interacting
with the patient until he/she is ready to open up. The Asian community tends to use
somatic terms to express mental issues to avoid bringing shame to their families.
Therefore, in the first few sessions, an Asian patient with mental disorders will focus
more on physical pain than emotional or psychological. However, the specialist
should not assume the client's complaints but offer comforting statements in return.
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Multicultural counseling requires the therapist to educate the patient on
psychotherapy by explaining the meaning of standard terms applied in the field. Also,
the doctor should differentiate psychotherapy from traditional healing practices (Hays
& Erford, 2018). While commencing psychotherapy, the most significant step is
assessing the degree of shame and humiliation experienced by a client. Also, Asian
patients expect quick results regardless of the intensity of their mental problems. Thus
all therapists seeing Asian clients should emphasize short-term treatment models such
as solution-focused therapy. This form of therapy emphasizes on the failed previous
solutions. From past experiences, the patient is urged to concentrate on the present
and the future.
One essential strategy for treating Asian-American patients undergoing mental
problems is medication. The Asian community believes they are trouble-free, and thus
expect medicines for any health issues. Before administering drugs, the psychologist
should enquire about any other traditional medicine taken by the patient (Jang, Park,
Chiriboga, & Kim, 2017). Also, the dose given to Asian-Americans should differ
from that of Whites due to changes in weight, sensitivity, and ethnicity.
Another practical approach is behavior therapy for it is direct and does not
emphasize on family or internal conflicts, which cause more shame to the patient.
Behavior therapy identifies mental disorders as habits a patient acquires through
learning, and can, therefore, be changed or unlearned (Hays, & Erford, 2018).
Cognitive behavior therapy is essential for Asian-Americans because it focuses on the
effects of one's cultural beliefs and thoughts on his/her actions.
Moreover, family therapy is highly recommended for Asians because the family
as a unit is more valued and respected than an individual. Also, the Asian culture
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encourages the sharing of information among family members; thus, it is rare to
discover hidden information that may cause more damage within a family. Research
shows that Asian patients expect high involvement of family members when attending
psychology therapy sessions (Jang, Park, Chiriboga, & Kim, 2017). Besides, the study
shows that Asian-Americans prefer their psychologists to share any progress with the
entire family other than the patient alone.
Group therapy is often not appropriate for Asian patients due to their culture of
not sharing problems or personal details with outside parties, especially Whites.
However, in cases where the patient has no family support of friends, which occurs
mostly in divorced Asians, group therapy can be useful (Jang, Park, Chiriboga, &
Kim, 2017). This form of treatment works even better when some Asian patients with
the same experiences as the client exist in the group.
Non-western approaches to therapy comprise of methods that have origins
outside Western advancements. They designate approaches rooted in indigenous
cultures and practices. Non-western therapy strategies antedate western formalization
of processes aiming at helping people with psychological needs (Hays, & Erford,
2018). There is a significant number of non-western therapy methods, including yoga,
meditation, and other cultural practices.
Psychologists treating Asian patients should avoid talk therapy for clients with
mild depression. The Asian population views talking to strangers about intimate
matters as betrayal or shame. Therefore, the doctor can focus on exercises such as
yoga to help patients with mild mental disorders. Yoga therapy is a field that is
continually growing, and its efficacy is evident. It employs yoga postures, breathing
exercises, and guided imagery in the improvement of both physical and mental health.
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Yoga therapy covers a wide range of therapeutic modalities while incorporating the
elements of both physical and psychotherapy (Hays, & Erford, 2018). Yoga is
employed in the treatment of physical and mental issues. It is more of a prevention
strategy.
Meditation therapy is another method of non-western based treatment. This type
of therapy involves relaxation and conscious expansion by focusing on a sound, word,
or image while eliminating the outside stimuli from one's consciousness. Meditation
helps in relaxation, mindfulness, and blood pressure reduction (Hays, & Erford,
2018). Also, it improves physical fitness and low back pains. It is valid for patients
with high levels of depression and anxiety, such as Asian-American women.
Morita therapy is a traditional approach in which feelings are considered as the
origin of one's current situation. It emphasizes purpose rather than emotions. This
form of treatment sees the sensitive faults in humans, and its focus is to help educate
about overcoming the limitations (Hays & Erford, 2018). This method involves week-
long rests without any distractions. Patients focus on daily activities to separate
feelings from behaviors.
Naikan therapy is also a non-western based therapy method that focuses on the
concepts that patients have done nothing on their own. This type of treatment aims at
inspiring the desire to repay others and encourage the expression of gratitude (Hays,
& Erford, 2018). There are a reflection and exploration of feelings that one can
control and ones they cannot. This type of therapy provides a teaching rather than a
medical model. From Naikan therapy, Asian-Americans can learn to appreciate what
they own rather than struggle to meet expectations portrayed by myths and
stereotypes.
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Religious and Spiritual Application
Faith-based programs, such as Buddhism, Judaism, Daoism, Confucianism and
Christianity in America, have significantly helped the Asian-American communities.
These programs have helped Asian-Americans deal with mental health issues. The
faith-based plans help in protecting the cultural groups of the Asia-Americans from
identity-related stress they face in America. Religious involvement is a means for
coping with challenges, distress, and discrimination (Ai, Appel, & Nicdao, 2016). It
also helps in counteracting the impact of discrimination against the Asian-Americans.
Those involved in religion and spirituality have a low incidence of depression and
self-rated mental health issues.
The Chinese subgroup believes that religion serves as a means of gaining an
understanding of the inter-cultural phenomena. They think that it provides an
understanding of cultural diversity and acculturation problems. They also agree that
through religious assimilation, they will have fewer cases of discrimination. On the
other hand, the Filipinos were not in agreement with acculturation (Ai, Appel, &
Nicdao, 2016). They are tied in ethnical identity and feel there is ambiguity in the
religious services offered. Their discrimination experiences and mistrust result in
lower levels of seeking mental healthcare. They faced the pressure of balancing two
cultures due to their suspicion. However, both the Filipinos and the Chinese subgroup
believe cross-generational acculturation consists of religious assimilation.
The church in Asian-American communities plays a role in maintaining cultural
identity, which is of great significance in life. The church and religious beliefs also
boost spiritual consolidation and is a means of social services provision (Ai, Appel, &
Nicdao, 2016). Asian-Americans culturally believe that there is no life after death.
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They think that when one dies, they are gone forever, and there is no reunion in the
afterlife.
In conclusion, Asian-American are the fastest growing diverse group in the
United States. Asian-Americans exhibit several strengths, including academic
success, hard work, family cohesion, and a high inner-drive. As a result, myths and
misconceptions have been attached to this culture, despite the limited research
conducted on them. Asian-Americans are at a higher risk of experiencing
psychological disorders in America but have the least probability of utilizing medical
facilities. Mental health problems are triggered by factors such as discrimination,
poverty, sexual harassment, language barrier, and cultural values. Treatment
procedures that are both linguistically and culturally competent will help reduce
mental disorders in the Asian community. Besides, religious approaches can be vital
in fighting psychological problems in minority races. In the future, researchers should
emphasize on specific Asian subgroups rather than a whole.
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References
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